Nose Re-Shaping (Rhinoplasty)

Before

After

Before

After

This woman in her 40s was unhappy with the large bump on the bridge of her nose and droopy tip. In addition she complained of troublesome breathing with a deviated septum and sinusitis. Dr. Julian De Silva completed a combined open rhinoplasty and septoplasty including reduction of her nasal bump. In addition he performed sculpting of her nasal tip and

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elevation of the nasal tip to a more attractive position. The reviewed photograph was taken approximately 8-weeks after surgery, the photograph shows an improved nasal profile, with a straight nose, attractive and natural looking nose, in addition to improvement in breathing. Additional photographs are on Dr. De Silva’s web site.

This man in his 20s was unhappy about the large size of his nose and large bump on his nasal bridge. On review of her photograph he had a relatively large nose in proportion to his relatively tall physique. Dr. Julian De Silva performed open rhinoplasty with a reduction of nasal hump with additional support of the bridge of his nose with sculpted grafts. In addition

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he underwent sculpting of the nasal tip cartilages with mild reduction of his projection (size of nose, position of the nose from the face). Review of the ‘post’ photograph shows a straight nose, subtle elevation of tip and a nose that is harmony with the proportions of his face.He was very happy with the final result and wrote the review below. The patient wrote this review “I had rhinoplasty performed. Leading up to the procedure, Dr Julian was very helpful and welcoming, along with his delightful team. The procedure went extremely well and am very happy with the result, I would recommend Dr Julian to anyone considering facial surgery. I would definitely use him again if I was considering a different procedure.”

This young Middle Eastern woman in her 20s was unhappy with a relatively large nose for her facial appearance and physique, the nasal bump and the relatively large bulbous nasal tip. Dr. Julian De Silva performed open ethnic rhinoplasty that included a reduction in the size of her nose, sculpting and specialised re-stitching with elevation of the nasal tip and the use of

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support grafts. On review of her photograph taken at 8-weeks after surgery, she has increased shape and definition of her nasal tip and almost invisible scar at 8-weeks after surgery. Recovery after Middle Eastern ethnic rhinoplasty often results in increased swelling in the nasal tip, Dr. Julian De Silva treats this with anti-inflammatory medications to speed up the recovery process.

This 23 year old woman was concerned about the relatively large size of the tip of her nose and width of the nostrils. On review of her photograph he had a relatively bulbous nasal tip and relative flaring of the nostrils. Dr. Julian De Silva performed open rhinoplasty with a shaping of the nasal tip cartilages with additional support of the bridge

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of his nose with sculpted grafts. In addition she underwent measured nostril reduction with hidden incisions and preserving normal breathing. Review of the ‘post’ photograph at 4-months shows a straight nose with refined nasal tip and reduced nostril size.

This 25 year old woman was concerned about the large bump on the bridge of her nose and relatively large size of her nose, she also was keen on conservative surgery and no “big change”. On review of her photograph she had a large nasal bump and over-projection of her nose. Dr. Julian De Silva performed rhinoplasty with a reduction of the

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nasal bump with additional support of the bridge of his nose with grafts to protect breathing and nasal function. In addition the nose was shortened and projection reduced again with supporting cartilage grafts. Review of the ‘post’ photograph at 6-weeks shows a straight nose with refined nasal tip and a natural looking result. The patient was able to return to work 10-days after surgery without fellow employees noticing her surgery. The woman was very happy with the natural looking results and fast recovery. The surgery is considered an ethnic rhinoplasty as the patient had relatively thick sin and weak nasal cartilages.

This woman in her 20s was unhappy with the large bump on the bridge of her nose and relatively large size of her nose. On review of her photographs she had a large nasal bump, a droopy nasal tip and deviation of the nose to her left side. Dr. Julian De Silva performed rhinoplasty with septoplasty including a reduction of her nasal bump with

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additional support of the bridge of his nose with grafts to protect nasal function. In addition the tip of her nose was elevated and projection reduced again with supporting cartilage grafts. Review of the ‘post’ photograph at 8-weeks shows a straight nose with improved profile, lifted nasal tip and straighter nose. The woman was very happy with the natural looking results.

This young woman was concerned about the width of her and relatively large tip, she also was keen on conservative surgery and no “big change”. On review of her photographs she had a wide tip with no light reflex and relatively wide nostrils. Dr. Julian De Silva performed rhinoplasty with shaping of the nasal tip cartilages. In addition the nostrils

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were narrowed. Review of the ‘post’ photograph at 4-weeks shows a more refined nasal tip with a light reflex, swelling is still present and the tip will continue to improve of the next 6 months. The patient was able to start a new job 10-days after surgery. The woman was very happy with the results.

This man in his 20s was unhappy about the large size of his nose and large bump on his nasal bridge. On review of her photograph he had a relatively large nose in proportion to his face with a large nasal hump. Dr. Julian De Silva performed rhinoplasty with a reduction of nasal hump using a micro burr which allowed fine control reduction with additional support of

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the bridge of his nose with grafts. In addition he underwent sculpting of the nasal tip cartilages with mild reduction of his projection (size of nose, position of the nose from the face). Review of the ‘post’ photograph which is taken only 1-week after surgery shows straight nose, subtle elevation of tip and a nose that is harmony with the proportions of his face. Although only one week after surgery and there is swelling present, a marked improvement can be seen.

This Afro-Caribbean woman in her 20s was unhappy with the shape of the bridge of her nose, bulbous tip and large nostrils. She had undergone previous rhinoplasty by a general plastic surgeon who had removed large amount of cartilage resulting in reduced nasal support, a septal hole and alar retraction.

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Dr. Julian De Silva completed a revision ethic rhinoplasty and septoplasty augmenting her nasal bridge with graft material giving her a smooth and more elegant nasal profile. Dr. De Silva shapes the graft material to the individual person so no two are identical. In addition Dr. De Silva supported her nose with supporting grafts to maintain the nasal architecture long-term. In addition Dr. De Silva used conservative techniques to reduce the size of her nostrils. The reviewed photograph was taken 6-weeks after surgery, the photograph shows an improved nasal profile, with a straight nose with reduced nostril show, and overall an attractive and natural looking nose. At 6-weeks after revision rhinoplasty there is still swelling in the tip of the nose, this will improve over the next 6-months and more definition will be apparent in the nasal tip. The patient was very happy with the results of her revision rhinoplasty.

This Middle Eastern woman in her 30s was very unhappy with the shape of the bridge of her nose following previous rhinoplasty surgery that had left her with an unattractive beak shape to her nasal bridge and droopy tip. Dr. Julian De Silva completed a revision ethic rhinoplasty and septoplasty, refining her

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nasal bridge with shaping of the underlying cartilage and supporting with autologous graft material to give her a smooth and more elegant nasal profile. In addition Dr. De Silva supported her nose with supporting grafts to maintain the nasal architecture long-term. The reviewed photograph was taken 1-week after surgery, the photograph shows an improved nasal profile and overall an attractive and natural looking nose. At only 1-week after surgery there is swelling present and this will continue to improve over the next 6-months as more definition will be apparent in the nasal bridge and nasal tip. The patient was very happy with the results of her revision rhinoplasty.

This African woman in her 40s was unhappy with the results of her previous surgery as it had made little difference to the appearance of her nose. With her African ethnicity the relative thickness of her skin and masked any change from her previous surgery with conventional techniques. Dr. Julian De Silva completed a revision ethic rhinoplasty and septoplasty,

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refining her nasal bridge with the use of medpor graft and supporting with autologous graft material to give her an improved nasal bridge and more elegant nasal profile. In addition Dr. De Silva supported her nose with supporting grafts to maintain the shape of her nose long-term. The reviewed photograph was taken 1-week after surgery, the photograph shows an improved nasal profile and overall an attractive and natural looking nose. At only 1-week after surgery there is swelling present and this will continue to improve over the next 6-months as more definition will be apparent in the nasal bridge and nasal tip. The patient was very happy with the results of her revision rhinoplasty.

This Middle Eastern man in his 30s was unhappy with a relatively large nose for his face, including a relatively wide and large nose with a droopy tip. Dr. Julian De Silva performed open ethnic rhinoplasty that included a reduction in the size of his nose, sculpting and specialised re-stitching with elevation of the nasal tip and the use of support grafts.

This Afro-Caribbean woman of mixed ethnicity in her 30s was unhappy with the shape of the bridge of her nose, bulbous tip and large nostrils. Dr. Julian De Silva completed an ethic rhinoplasty and septoplasty reducing her nasal bridge with graft material giving her a smooth and more elegant nasal profile, and lifting her tip to correct the

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droopiness of her nasal tip. Dr. De Silva shapes the graft material to the individual person so no two are identical. In addition Dr. De Silva supported her nose with supporting grafts to maintain the nasal architecture long-term. The reviewed photograph was taken 5-weeks after surgery, the photograph shows an improved nasal profile, with a gently curved nose and overall an attractive and natural looking nose. The patient was very happy with the results of her rhinoplasty.

This South Asian woman in her 20s did not like her large nasal bump, wide tip and general size of her nose. She was an athlete and breathing was an important aspect of her concerns. She presented to Dr. De Silva from abroad to undergo rhinoplasty. Dr. De Silva performed ethnic rhinoplasty with septoplasty using twilight anaesthesia

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The patient was very happy with the results at one week and left London, 10-days after undergoing rhinoplasty.

This Caucasian man in his 20s did not like the width of his nose and was looking for a conservative improvement in the size and width of his nose, while maintaining his natural profile and shape. He conducted a thorough search to find a plastic surgeon who would be able to complete his request. On meeting with Dr. De Silva, both his objectives from surgery and expectations were discussed. He underwent rhinoplasty with septoplasty under sedation anaesthesia (twilight anaesthesia). Dr. De Silva utilised specialised cartilage techniques to refine and reshape the cartilages narrowing both the bridge of his nose and nostrils. The incisions were hidden at the base of the nose and could not be seen several weeks after surgery.

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He was very happy with the results of his surgery which can be seen in the form a daily video diary.

This Asian man in his 30s was unhappy with his two previous rhinoplasties that had resulted in a marked bend in the shape of his bridge that had left him with an unattractive shape to his nasal bridge and mild droopy tip. Dr. Julian De Silva completed a revision asian rhinoplasty and septoplasty, refining his nasal bridge with shaping of the underlying cartilage and supporting with autologous graft material to give him a smooth and more elegant nasal profile. In addition Dr. De Silva supported his nose with supporting grafts to maintain the nasal architecture long-term.

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The reviewed photograph was taken 6-months after surgery, the photograph shows an improved nasal profile and overall an attractive and natural looking nose. The patient was very happy with the results of her revision rhinoplasty and went onto have a further revision procedure with Dr. Julian De Silva.

This Asian woman in her 20s described a combination of a relatively large nose with a bump and boxy tip with difficult breathing. She looked for a surgeon who would be able to both improve her breathing and the appearance of her nose. After a detailed consultation with Dr. De Silva she underwent open ethnic rhinoplasty with septoplasty under sedation anaesthesia. Dr. De Silva shaped her nasal tip cartilage with a combination of sculpting technqiues and special stitches, reduced her nasal bump with the signatures specialised micro-instrument and improved her breathing with a combination septoplasty and turbinate procedure.

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After surgery her breathing was markedly improved and the after photographs taken only 6-weeks after surgery show a refined nasal tip, feminine nasal bridge and subtly raised nasal tip. The patient was very happy with the natural looking final result.

This Caucasian woman in her 20s was concerned about the relatively large size of the tip of her nose size and size. On review of her photograph he had a relatively bulbous nasal tip and droopy nasal tip. Dr. Julian De Silva performed open rhinoplasty with a shaping of the nasal tip cartilages with additional support of the bridge of his nose with sculpted grafts. Review of the ‘post’ photograph shows a more refined nasal tip with subtle elevation of her nose keeping the same characteristics of her face at the same time as shortening her nose and resulting in better facial harmony.

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Before the surgery she had been very anxious about undergoing rhinoplasty under sedation anaesthesia, however was very happy with her decision as she had a speedy recovery with minimal swelling and no bruising.

This young woman in her 20s did not like the shape of her nose including a bump and droopy tip. She looked to find a plastic surgeon who would be able to help her with this. On meeting with Dr. De Silva, both her objectives from surgery and expectations were discussed. She underwent rhinoplasty with septoplasty under sedation anaesthesia (twilight anaesthesia). Dr. De Silva utilised specialised micro-burr, and cartilage techniques to refine and reshape the cartilages narrowing both the bridge of his nose and subtly lifting the tip of her nose.

This African man in his 20s was unhappy with the appearance of his nose the relatively large width and absence of definition. With a consequence of his ethnicity the anatomy of his nose was characaterised by a relatively broad nose with low bridge and large nostrils.

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The reviewed photograph was taken only 6-weeks after surgery; the photograph shows an improved nasal profile and a narrow more balanced looking nose. At only 6-weeks after African rhinoplasty surgery there is swelling present and this will continue to improve over the next 12-months as more definition will be apparent in the nasal bridge and nasal tip.

Patient took Selfie photo of their appearance 1-week after combined Primary Rhinoplasty with Chin Implant under Twilight Anesthesia with Dr. Julian De Silva.

This woman in her 20s was unhappy with size and shape of both her nose and chin. She looked for a surgeon who would be able to both improve the appearance including her nose and face with an artistic eye. After a detailed consultation with Dr. De Silva she underwent a rhinoplasty with chin augmentation under sedation anaesthesia.

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After surgery she took a selfie photo at 1-week after the surgery that showed a marked improvement in her facial balance. The after photographs taken only 6-weeks after surgery show a refined nasal tip, feminine nasal bridge and shaped nasal tip. The patient was very happy with the final result.

This Caucasian woman did not like the shape of her nose including a bump and droopy tip. She looked to find a plastic surgeon who would be able to help her with this. On meeting with Dr. De Silva, both her objectives from surgery and expectations were discussed. She underwent an open rhinoplasty with septoplasty under sedation anaesthesia (twilight anaesthesia). Dr. De Silva utilised specialised micro-burr, and cartilage techniques to refine and reshape the cartilages narrowing both the bridge of his nose and subtly lifting the tip of her nose.

This man was unhappy with the asymmetry of his nose on the front view and relatively large size of his nasal tip. He looked for a surgeon specialising in the face who would be able to improve the appearance of his nose. After an assessment and discussion with Dr. De Silva he underwent an open rhinoplasty under sedation anaesthesia. Dr. De Silva shaped his nasal tip cartilage and utilised cartilage from his septum as graft tissue to improve his symmetry. The after photographs show a straighter nose with a refined nasal tip, more in balance with his face.

This woman was unhappy with shape of both her nose and had previously undergone filler treatment with limited results. She looked for a surgeon who would be able to both improve the appearance including her nose and face with an artistic eye. After consultation with Dr. De Silva she underwent a rhinoplasty under sedation anesthesia. Dr. De Silva allows extra time for every patients surgery and removing the filler took almost 1-hour longer than planned. The patient was very happy with the final result.

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Before the surgery she had been very anxious about undergoing rhinoplasty under sedation anaesthesia, however was very happy with her decision as she had a speedy recovery with minimal swelling and no bruising. The patient was very happy with the final result

This Caucasian woman was concerned about the relative size of her nose size and shape. She came to see Dr. Julian De Silva as a specialist in Facial Plastic Surgery for refinement of her nose. Dr. De Silva completed a refinement rhinoplasty with conservative lifting and shaping of nasal tip and reduction of her bridge to give a more feminine shape. Review of the ‘post’ photograph shows a more refined nasal tip with subtle elevation of her nose keeping the same characteristics of her face at the same time as shortening her nose and resulting in better facial harmony.

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Before the surgery she had been very anxious about undergoing rhinoplasty under sedation anaesthesia, however was very happy with her decision as she had a speedy recovery with minimal swelling and no bruising. The patient was very happy with the final result

This teenager had difficulty breathing as a consequence of deviated septum. In addition she had a bump on the bridge of her nose that had bothered her for many years. Dr. De Silva completed teenage rhinoplasty and septoplasty for her. She had a speedy recovery with an improvement in her breathing after rhinoplasty in addition to improving the shape of her nose.

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Before the surgery she had been very anxious about undergoing rhinoplasty under sedation anaesthesia, however was very happy with her decision as she had a speedy recovery with minimal swelling and no bruising. The patient was very happy with the final result

This young woman was looking to improve the shape of her nose while looking the same and keeping a natural result. She had a relatively long nose with bump on the bridge of her nose. The patient underwent rhinoplasty with septoplasty under twilight sedation with Dr. De Silva. The photos shown at only 6-weeks shows an improved nose with lifting of the tip, shaping of the bridge and tip and improved straightness.

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Before the surgery she had been very anxious about undergoing rhinoplasty under sedation anaesthesia, however was very happy with her decision as she had a speedy recovery with minimal swelling and no bruising. The patient was very happy with the final result

This woman in her 20s was unhappy with size and shape of both her nose and chin. She looked for a surgeon who would be able to both improve the appearance including her nose and face with an artistic eye. After a detailed consultation with Dr. De Silva she underwent a rhinoplasty with chin augmentation under sedation anaesthesia. Dr. De Silva shaped her nasal bridge reducing the high bridge to make a smooth and even bridge, and improved the lower third of her face with chin augmentation.

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Before the surgery she had been very anxious about undergoing rhinoplasty under sedation anaesthesia, however was very happy with her decision as she had a speedy recovery with minimal swelling and no bruising. The patient was very happy with the final result

This Caucasian woman in her 20s did not like her the general size or shape of her nose and had the misfortune of multiple traumatic sporting injuries to her nose. The appearance of her nose showed a relatively wide tip and mildly droopy tip and was mildly large and out of proportion. Dr. De Silva performed rhinoplasty with septoplasty using twilight anaesthesia, she recovered over a 30-minute period after her surgery and was able to go home half an hour after her surgery.

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Before the surgery she had been very anxious about undergoing rhinoplasty under sedation anaesthesia, however was very happy with her decision as she had a speedy recovery with minimal swelling and no bruising. The patient was very happy with the final result

This African man in his 20s was unhappy with the appearance of his nose the relatively large width and absence of definition. With a consequence of his ethnicity the anatomy of his nose was characterized by a relatively broad nose with low bridge and large nostrils. Dr. Julian De Silva completed an ethic rhinoplasty that included specific grafting techniques to improve the definition in his nasal bridge and tip in addition to conservative narrowing of his nostrils.

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Before the surgery she had been very anxious about undergoing rhinoplasty under sedation anaesthesia, however was very happy with her decision as she had a speedy recovery with minimal swelling and no bruising. The patient was very happy with the final result

This South Asian woman dislike the prominent bump on the bridge on her nose. She came from family with all close family members had a bump on their nose and she did not want a full correction of the bump. After a thorough consultation with Dr. De Silva, rhinoplasty was completed without a full correction of the bridge of her nose.

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Before the surgery she had been very anxious about undergoing rhinoplasty under sedation anaesthesia, however was very happy with her decision as she had a speedy recovery with minimal swelling and no bruising. The patient was very happy with the final result

This Caucasian woman in her 20s did not like her the general shape of her nose which did not suit her professional appearance. The appearance of her nose showed a relatively wide tip and mildly droopy tip. Dr. De Silva performed rhinoplasty with septoplasty using twilight anaesthesia. At this early stage after surgery, despite swelling her nose looks smaller, more feminine and has a natural appearance.

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Before the surgery she had been very anxious about undergoing rhinoplasty under sedation anaesthesia, however was very happy with her decision as she had a speedy recovery with minimal swelling and no bruising. The patient was very happy with the final result

This Afro-Carribean woman in her 30s did not like the appearance of her nose the relatively large width and absence of definition. With a consequence of her ethnicity the anatomy of his nose was characterised by a relatively thick skin with a low bridge and large nostrils. Dr. Julian De Silva completed an ethic rhinoplasty that included specific grafting techniques to improve the definition in her nasal bridge and tip in addition to conservative narrowing of his nostrils.

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Before the surgery she had been very anxious about undergoing rhinoplasty under sedation anaesthesia, however was very happy with her decision as she had a speedy recovery with minimal swelling and no bruising. The patient was very happy with the final result

This woman did not like her the general size or shape of her nose and wished for a very conservative result. Dr. De Silva completed rhinoplasty for her, maintaining the appearance of her nose with a conservative reduction in her nasal bump and a natural looking appearance. The patient was very happy with the results from her rhinoplasty.

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Before the surgery she had been very anxious about undergoing rhinoplasty under sedation anaesthesia, however was very happy with her decision as she had a speedy recovery with minimal swelling and no bruising. The patient was very happy with the final result

This woman was looking to improve the shape of her nose while looking the same and keeping a natural result. She had a relatively long nose with high bump on the bridge of her nose. At her consultation Dr. De Silva advised her to have chin augmentation with her rhinoplasty to improve the final result by improving her facial balance.

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The patient underwent rhinoplasty with septoplasty with chin augmentation under twilight sedation with Dr. De Silva. The photos shown at only 6-weeks shows an improved nose with lifting of the tip, shaping of the bridge and tip and improved straightness. The patient was happy with the results from her rhinoplasty.

This young woman was looking to improve the shape of her nose while looking the same and keeping a natural result. She had a relatively large nose with bump on the bridge of her nose and a bulbous tip. The patient underwent rhinoplasty with septoplasty under twilight sedation with Dr. De Silva.

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The photos shown at only 6-weeks shows an improved nose with lifting of the tip, shaping of the bridge and tip and improved straightness. Refining of the cartilage in the tip of the nose with rhinoplasty can be a challenging and result in swelling, the final result is many months after the surgery when all the swelling has resolved. The patient was happy with the results from her rhinoplasty. Click here to view video testimonial.

This Asian man did not like the size of his nose with a large hump and large nasal tip. He Had thick ethnic skin that limits the definition of the nasal tip. Dr. De Silva advised him to undergo open rhinoplasty to enable specific techniques to enhance nasal tip refinement in patients with thicker ethnic skin.

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In addition Dr. De Silva utilises anti-swelling medication after surgery to improve the results further. The after photo shows a smaller more refined nose that is more in balance with his ethnicity

This Asian woman did not like the shape of her nose including a bump and droopy tip. She looked to find a plastic surgeon who would be able to help her with this. On meeting with Dr. De Silva, both her objectives from surgery and expectations were discussed.

Read more

She underwent an open rhinoplasty with septoplasty under sedation anaesthesia (twilight anaesthesia). Dr. De Silva utilised specialised micro-burr, and cartilage techniques to refine and reshape the cartilages narrowing both the bridge of his nose and subtly lifting the tip of her nose. She was very happy with the results of her natural looking surgery. Click here to view video testimonial.

This woman in her 20s was concerned about the relatively large size of the tip of her nose and shape. On review of her photograph he had a relatively bulbous nasal tip and droopy nasal tip. Dr. Julian De Silva performed open rhinoplasty with a shaping of the nasal tip cartilages with additional support of the bridge of his nose with sculpted grafts.

Read more

Review of the “post” photograph shows a more refined nasal tip with subtle elevation of her nose keeping the same characteristics of her face at the same time as shortening her nose and resulting in better facial harmony. Before the surgery she had been very anxious about undergoing rhinoplasty under sedation anaesthesia, however was very happy with her decision as she had an enhanced recovery with minimal swelling and no bruising. Click here to view video testimonial.

This ethnic woman in her 30s did not like the appearance of her nose following undergoing rhinoplasty with a local plastic surgery. With a consequence of her ethnicity the anatomy of her nose was characterised by relatively thick skin, wide nasal tip and large asymmetrical nostrils.

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Dr. Julian De Silva specialises in ethnic rhinoplasty and completed a revision ethic rhinoplasty that included specific grafting techniques to improve the definition in her nasal tip in addition to conservative narrowing of her nostrils. Dr. De Silva supported her nose with supporting grafts to maintain the shape of her nose long-term. The reviewed photograph was taken 3-months after surgery, the photograph shows an improved nasal tip and a narrow more balanced looking nose. At 3-months after ethnic rhinoplasty surgery there is swelling present and this will continue to improve over the next 12-months as more definition will be apparent in the nasal bridge and nasal tip. The patient was very happy with the results of her surgery.

This Asian woman did not like the appearance of her nose the relatively large width and low bridge. With a consequence of her ethnicity the anatomy of his nose was characterised by a relatively thick skin and a low nasal bridge.

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Dr. Julian De Silva completed an Asian rhinoplasty that included specialised grafting techniques to improve the definition in her nasal bridge and tip in addition to conservative narrowing of his nostrils. Dr. De Silva supported her nose with supporting grafts to maintain the shape of her nose long-term. The reviewed photograph was taken several months after surgery, the photograph shows an improved nasal profile and a narrow more balanced looking nose. At 6-month after Asian rhinoplasty surgery there is swelling present and this will continue to improve over the next 12-months as more definition will be apparent in the nasal bridge and nasal tip.

This woman had not liked the overall shape of her nose including a nasal bump and undefined nasal tip. She looked to find a facial plastic surgeon who would be able to help her with this.

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On meeting with Dr. De Silva, spent time to discuss her nose as she was looking for conservative “refinement” rhinoplasty. She underwent rhinoplasty with septoplasty under twilight anaesthesia with Dr. De Silva. Dr. De Silva utilized specialised micro-burr, and cartilage techniques to refine and reshape the cartilages narrowing both the bridge of her nose and subtly lifting the tip of her nose. She was very happy with the results of her natural looking surgery. Click here to view video testimonial.

This Middle Eastern man in his 20s was unhappy about the large size of his nose and large bump on his nasal bridge. On review of his photograph he had a relatively large nose in proportion to his face with a large nasal hump.

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Dr. Julian De Silva performed rhinoplasty with a reduction of nasal hump using a micro burr which allowed fine control reduction with additional support of the bridge of his nose with grafts. In addition he underwent sculpting of the nasal tip cartilages with mild reduction of his projection (size of nose, position of the nose from the face). Review of the “after” photograph shows a nose that is harmony with the proportions of his face. Six weeks after surgery although there is swelling present, a marked improvement can be seen, the patient was very happy with the final result.

This woman had not liked the shape of her nose including a bump and droopy tip for over twenty years. She looked to find a facial plastic surgeon who would be able to help her with this. On meeting with Dr. De Silva, both her objectives from surgery and expectations were discussed.

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She underwent rhinoplasty with septoplasty under twilight anaesthesia. Dr. De Silva utilised specialised micro-burr, and cartilage techniques to refine and reshape the cartilages narrowing both the bridge of his nose and subtly lifting the tip of her nose. She was very happy with the results of her natural looking surgery. Request a consultation at our office in London to take the next step and learn more about your cosmetic options. You can call the London Centre for Advanced Facial Cosmetic Surgery at 020 8748 2860 to schedule your appointment with Dr. De Silva. Click here to view video testimonial.

This man in his 30s was unhappy about the large size of his nose and large bump on his nasal bridge. On review of his photograph he had a relatively large nose in proportion to his face with a large nasal hump. He had wanted very natural looking surgery so that is work colleagues and friends would not be able to tell her underwent surgery.

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Dr. Julian De Silva performed rhinoplasty with a reduction of nasal hump using a micro burr which allowed fine control reduction with additional support of the bridge of his nose with grafts. In addition he underwent sculpting of the nasal tip cartilages with mild reduction of his projection (size of nose, position of the nose from the face). Review of the “after” photograph shows a nose that is harmony with the proportions of his face. Six weeks after surgery although there is swelling present, a marked improvement can be seen, the patient was very happy with the final result. The patient took two weeks off work and the result from his surgery was natural, none of his work colleagues were able to tell he had undergone surgery. Dr. De Silva specialises in natural looking results and with rhinoplasty the surgery can be tailored to the individual needs of each patient, for this reason surgery takes between 2 and half to 3 hours for most patients.

This young woman in her 20s had not liked her nose for many years, she had particularly noticed a aide tip and increasing bump on the bridge of her nose. She looked for a facial cosmetic surgeon who would be able to both improve the appearance of her nose for an important event coming up in the summer.

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After a detailed consultation with Dr. De Silva she underwent a rhinoplasty with septoplasty under sedation anaesthesia. Dr. De Silva shaped her nasal tip cartilage with a combination of sculpting techniques and special stitches, reduced her nasal bump with the signatures specialised micro-instrument and improved her breathing with a combination septoplasty and turbinate procedure. She had very thin skin and Dr. De Silva used specialised graft material to enhance the quality of her skin to give her a better long-term result for years to come. After surgery her nose was markedly improved and the after photographs taken only 6-weeks after surgery show a refined nasal tip, feminine nasal bridge and subtly raised nasal tip. The patient was very happy with the natural looking final result.

This woman had not liked her nose for more than ten years, she had particularly noticed a high bump on the bridge of her nose. She looked for a facial cosmetic surgeon who would be able to both improve the appearance of her nose as her profession required substantial travelling and people skills.

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After a detailed consultation with Dr. De Silva she underwent a rhinoplasty with septoplasty under sedation anaesthesia. Dr. De Silva shaped her nasal bridge with a combination of sculpting techniques and high-tech instruments, reduced her nasal bump and used specialised graft material to enhance the quality of her skin. After surgery her nose was markedly improved and the after photographs taken only 6-weeks after surgery show a natural appearance with feminine nasal bridge. The patient was very happy with the natural looking results.

This woman with mixed Asian ethnicity did not like the appearance of her nose the relatively large width, high nasal bridge and difficulty breathing secondary to a deviated septum. She looked for a surgeon who would be able to both improve her breathing and the appearance of her nose.

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After a detailed consultation with Dr. De Silva she underwent open ethnic rhinoplasty with septoplasty under sedation anaesthesia. Dr.De Silva shaped her nasal tip cartilage with a combination of sculpting technqiues and special stitches, reduced her nasal bump with the signature specialised micro-instrument and improved her breathing with a combination septoplasty and turbinate procedure. After surgery her breathing was markedly improved and the after photographs taken 3-months after surgery show a refined nasal tip, feminine nasal bridge and subtly raised nasal tip. Dr. De Silva supported her nose with supporting grafts to maintain the shape of her nose long-term. The reviewed photograph was taken several months after surgery, the photograph shows an improved nasal profile and a narrow more balanced looking nose. At 3-months after ethnic rhinoplasty surgery there is swelling present and this will continue to improve over the next 12 months as more definition will be apparent in the nasal bridge and nasal tip.

This man in his 30s was unhappy about the large size of his nose and large bump on his nasal bridge. On review of his photograph he had a relatively large nose in proportion to his face with a large nasal hump. He had wanted very natural looking surgery so that is work colleagues and friends would not be able to tell her underwent surgery. 1-Week After Rhinoplasty6-Weeks After Rhinoplasty

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Dr. Julian De Silva performed an ethnic rhinoplasty with a reduction of nasal hump using a micro burr which allowed fine control reduction with additional support of the bridge of his nose with grafts. In addition he underwent sculpting of the nasal tip cartilages with mild reduction of his projection (size of nose, position of the nose from the face). Review of the “after photographs are shown at 1-week and at 6-weeks. At 1-week an improvement in his profile can be seen, although a normal amount of swelling is present. At 6-weeks after surgery although there is swelling present, a marked improvement can be seen, with a more balanced profile and the patient was very happy with the results. The patient took two weeks off work and the result from his surgery was natural. Dr. De Silva specialises in natural looking ethnic rhinoplasty, each surgery is tailored to the individual needs of each patient, for this reason ethnic rhinoplasty takes 3 hours for most patients.

This ethnic woman did not like the appearance of her nose the relatively size and shape. With a consequence of her ethnicity the anatomy of her nose was characterised by a relatively thick skin with a low bridge and nasal bump.

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Dr. Julian De Silva completed an ethic rhinoplasty that included specific grafting techniques to improve the definition in her nasal bridge and tip in addition to shaping the nasal bridge. Dr. De Silva supported her nose with supporting grafts to maintain the shape of her nose long-term. The reviewed photograph was taken several months after surgery, the photograph shows an improved nasal profile and a narrow more balanced looking nose. Dr. De Silva uses anti-swelling medicine after surgery to enhance recovery time, reduce swelling and improve the final definition in the nasal tip. After ethic rhinoplasty surgery there is swelling present and this will continue to improve over the next 12-months as more definition will be apparent in the nasal bridge and nasal tip. Click here to view video testimonial.

This caucasian woman did not like the shape of her nose including a bump and a bulbous tip. She looked to find a facial plastic surgeon specializing in rhinoplasty to help her with this.

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On meeting with Dr. De Silva, both her objectives from surgery and expectations were discussed. She underwent an open rhinoplasty with septoplasty under sedation anaesthesia (twilight anaesthesia). Dr. De Silva utilised specialised micro-burr, and cartilage techniques to refine and reshape the cartilages narrowing both the bridge of his nose and naturally shape tip of her nose. She was very happy with the results of her natural looking surgery.

This Caucasian woman had experienced unfortunate trauma to her nose that resulted in a sunken bridge, that had markedly changed her facial appearance.

Read more

She looked for a facial plastic surgeon who would be able to help restore the natural appearance of her including her bridge. After a detailed consultation with Dr. De Silva she underwent a revision rhinoplasty with under sedation anaesthesia. Dr. De Silva shaped utilised specialised graft material and surgical techniques to restore her natural bridge and nose shape. Dr. De Silva also improve her symmetry and breathing as her nose after the trauma had become twisted to the left side. Dr. De Silva discusses with each patient realistic expectations from surgery as perfection is very challenging to achieve. The after photos at 6months show a markedly improved of her nasal bridge, resulting in her achieving the same appearance and shape that she had before her injury. The patient was very happy with the natural looking final result.

This Caucasian woman was very unhappy with the shape of her nose following previous rhinoplasty surgery that had left her with an unattractive shape to her nasal bridge and marked nostril show.

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Dr. Julian De Silva completed a revision rhinoplasty and septoplasty, refining her nasal bridge with shaping of the underlying cartilage and supporting with autologous graft material to give her a smooth and more elegant nasal profile. Dr. De Silva supported her nose with supporting grafts to maintain the nasal architecture long-term. Dr. De Silva was able to improve the definition and shape in her nose including reducing the amount of her nostril show. The patient was very happy with the results of her revision rhinoplasty. https://www.youtube.com/watch?v=b9YuJdvlvJ0

This Young Asian woman did not like the general shape of her nose including wide nose with lack of definition in her tip and low bridge.

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She looked to find a plastic surgeon who specialized in Asian Rhinoplasty to achieve the best possible improvement. On meeting with Dr. De Silva, both her objectives from surgery and expectations were discussed, one of the characteristics of her ethnicity included thicker ethnic skin that requires specialist techniques to improve. She underwent an open Asian rhinoplasty and Dr. De Silva utilised specialist graft and cartilage techniques to give her improved definition and a more elegant nasal profile with narrower and more elegant features. The after photographs is at only at 2months and the tip will further improve over an 18-month period after Asian Rhinoplasty. Dr. De Silva utilised anti-swelling medication after surgery on several occasions to further improve the definition and shape of her nose after Asian Rhinoplasty. She was very happy with the results of her natural looking surgery.

This man in his 20s had been unhappy with the shape of his nose and high bridge for many years. In addition he had an uneven twisted tip and deviated septum.

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He looked for a surgeon specialising in rhinoplasty who would be able to both improve the appearance if his nose while maintaining a natural appearance. After a thorough consultation with Dr. De Silva he underwent a rhinoplasty with septoplasty under twilight anaesthesia. Dr. De Silva shaped his nasal bridge to make a smooth and even bridge, using specialist graft material to ensure the bridge was kept straight. The after photographs taken 3-months after surgery show an improved masculine straight nasal bridge and refined nasal tip. The patient was very happy with the final result.

This woman in her 20s had not liked the overall shape of her nose including a nasal bump and undefined nasal tip for many years.

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She looked to find a facial plastic surgeon who would be able to help her with this. On meeting with Dr. De Silva, spent time to discuss her nose as she was looking for conservative rhinoplasty. She underwent rhinoplasty with septoplasty under twilight anaesthesia with Dr. De Silva. Dr. De Silva utilised specialised micro-burr, and cartilage techniques to refine and reshape the cartilages narrowing both the bridge of her nose and subtly lifting the tip of her nose. She was very happy with the results of her natural looking surgery.

This woman in her 201 had not liked her nose since her teenage years, she had particularly noticed a high bump on the bridge of her nose and the wide tip.

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She looked for a facial cosmetic surgeon who would be able to both improve the appearance of her nose as she did not want other people to know she had undergone surgery. After a detailed consultation with Dr. De Silva discussed with her expectations from surgery and limitations including relatively thick skin. Dr. De Silva shaped her nasal bridge with a combination of sculpting techniques and high-tech refining instrument, reduced her nasal bump and shaped her nasal tip using specialised graft material to enhance the quality of her skin. After surgery her nose was markedly improved and the after photographs taken only 6-weeks after surgery show a natural appearance with feminine nasal bridge. The patient was very happy with the natural looking results.

This woman in her 20s had not liked her nose for many years, she had particularly noticed the bump on the bridge of her nose, asymmetry and overall size and projection.

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She looked for a facial plastic surgeon who would be able to both improve the appearance of her nose. After a detailed consultation with Dr. De Silva she underwent a rhinoplasty with septoplasty under sedation anaesthesia. Dr. De Silva shaped her nasal bridge with a combination of sculpting techniques and high-tech instruments, reduced her nasal bump. In addition he found asymmetry in the underlying cartilages in the tip of her nose that were refined and improved. After surgery her nose was markedly improved and the after photographs show a natural appearance with feminine nasal bridge. The patient was very happy with the natural looking results.

This man in his 30s was unhappy about the size and shape of his nose, having previously undergone unsuccessful surgery on his nose by a local surgeon.

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On review of his photograph he had a relatively large nose in proportion to his face with a large nasal hump as well as hanging columellar and twisted asymmetrical tip. He had wanted very natural looking surgery so that is work colleagues and friends would not be able to tell her underwent surgery. Dr. Julian De Silva performed an ethnic rhinoplasty with a reduction of nasal hump using a micro burr which allowed fine control reduction with additional support of the bridge of his nose with grafts. In addition he underwent sculpting of the nasal tip cartilages with mild reduction of his projection (size of nose, position of the nose from the face) as well as lifting of his nose. Review of the ‘after photographs are shown at 8-weeks. After surgery although there is swelling present, a marked improvement can be seen, with a more balanced profile and the patient was very happy with the results. Dr. De Silva specialises in natural looking ethnic rhinoplasty, each surgery is tailored to the individual needs of each patient, for this reason ethnic rhinoplasty takes 3 hours for most patients.

This woman in her 30s had not liked her nose for many years, she had previously seen a local plastic surgeon who had advised her she could not undergo rhinoplasty as her nose tip and bridge could not be improved significantly.

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Initially she was disappointed and then looked for a facial plastic surgeon who specialised in rhinoplasty who may be able to help her. She can for an appointment with Dr. Julian De Silva who spent time discussing with her what he would be able to both improve in terms of rhinoplasty and realistic expectations form surgery. After a detailed consultation with Dr. De Silva she underwent an open rhinoplasty with septoplasty under sedation anaesthesia. Dr. De Silva shaped her nasal tip cartilage with a combination of sculpting techniques and special stitches, reduced her nasal bump with the signatures specialised micro-instrument and improved her breathing with a combination septoplasty and turbinate procedure. Dr. De Silva prefers to use an open approach in patients with large boxy shaped nasal tips as this enables accurate sculpting of the cartilages in the tip of the nose as well as measurements to the nearest half a millimetre. She had very thin skin and Dr. De Silva used specialised graft material to enhance the quality of her skin to give her a better long-term result for years to come. After surgery her nose was markedly improved and the after photographs taken only 6-weeks after surgery show a refined nasal tip, feminine nasal bridge and subtly raised nasal tip. The patient was very happy with the natural looking final result.

This woman had not liked the overall shape of her nose including a nasal bump and undefined nasal tip. She looked to find a facial plastic surgeon who would be able to help her with this.

Read more

On meeting with Dr. De Silva, spent time to discuss her nose as she was looking for conservative “refinement” rhinoplasty. She underwent rhinoplasty with septoplasty under twilight anaesthesia with Dr. De Silva. Dr. De Silva utilised specialised micro-burr, and cartilage techniques to refine and reshape the cartilages narrowing both the bridge of her nose and subtly lifting the tip of her nose. The final result with open rhinoplasty show a conservative natural refinement with a hidden scar. She was very happy with the results of her natural looking surgery.

This man in his 30s was unhappy about the size of his nose and hump on his nasal bridge. He had undergone previous rhinoplasty surgery by a plastic surgery that had not been effective.

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On review of his photograph he had a relatively large nose in proportion to his face with a large nasal hump. He had wanted very natural looking surgery so that is work colleagues and friends would not be able to tell her underwent surgery. Dr. Julian De Silva performed an ethnic rhinoplasty with a reduction of nasal hump using a micro burr which allowed fine control reduction with additional support of the bridge of his nose with grafts. In addition he underwent sculpting of the nasal tip cartilages with mild reduction of his projection (size of nose, position of the nose from the face). Review of the after photographs are shown at 8-weeks, an improvement in his profile can be seen, although a normal amount of swelling is present. The patient was very happy with the results, as his result was natural. Dr. De Silva specialises in natural looking rhinoplasty, each surgery is tailored to the individual needs of each patient.

This man in his 50s had experienced multiple traumas to his nose that resulted in an uneven appearance, raised hump. He looked for a facial plastic surgeon who would be able to help restore the natural appearance of his including her bridge.

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In addition he was unhappy about the relatively small size of his chin. On review of his photograph he had a relatively small chin that is recessed far behind his lower lip. The chin is an important masculine characteristic of the face and a small chin results in weakened jaw line. After a detailed consultation with Dr. De Silva she underwent a rhinoplasty and chin augmentation under sedation anaesthesia. Dr. De Silva shaped utilised specialised graft material and surgical techniques to restore her natural bridge and nose shape. Dr. De Silva also improve her symmetry and breathing as his nose after the trauma. Dr. De Silva discusses with each patient realistic expectations from surgery as perfection is very challenging to achieve. The after photos at 3months show a markedly improved of his nasal bridge and a chin that was more in proportion to the rest of his face. The patient was very happy with the natural looking final result.

This Asian woman did not like the shape of his nose with a modest hump and relatively wide nasal tip. Before surgery, Dr. De Silva discussed with her expectations from surgery and limitations including her thicker ethnic skin that limits the definition of the nasal tip.

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Dr. De Silva advised her to undergo open rhinoplasty to enable specific techniques to enhance nasal tip refinement in patients with thicker ethnic skin. The after photo shows a smaller more refined nose that is more in balance with his ethnicity, the nose has a natural appearance and shape. The after photograph shown at 3months still has swelling present, with the final result more than twelve months after surgery. The patient was very happy with the results of her surgery.

This Asian woman in her 20s did not like how prominent her nose was, especially with certain angles the hump on the bridge of her nose catching the light.

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She wanted to balance her nose with the rest of her features she started researching different rhinoplasty surgeons and decided to contact the London Centre for Advanced Facial Cosmetic Surgery for a consultation. When she came in for her appointment, she expressed her concerns to her surgeon and told him how the width of her nose, along with the size and the shape of the tip, truly bothered her. She wanted to have a more refined nose with improved bridge. After listening to her concerns, her surgeon, Dr. De Silva assured her that he could achieve the results she wanted using a closed rhinoplasty technique. By hiding all small incisions inside the nostril, her surgeon was able to sculpt the nasal cartilages and reshape the bone avoiding and cuts in the skin and without having to leave visible scarring. The final result shows the appearance of her nose only 1-week after surgery. There was a marked improvement in the shape of her nose with minimal swelling and no bruising. With Dr. De Silva’s novel techniques only 10% of his patients have bruising after surgery, and most bruising if it does occur is relatively mild and resolves within 2 weeks.

This woman in his 20s was unhappy about the size and shape of her nose, with a high hump on the bridge of her nose and relatively large over-projected nose.

Read more

On review of her photographs he had a relatively large nose in proportion to his face with a large nasal hump. She had wanted very natural looking surgery. Dr. Julian De Silva performed an open rhinoplasty with a reduction of nasal hump using a micro burr which allowed fine control reduction with additional support of the bridge of his nose with grafts. In addition he underwent sculpting of the nasal tip cartilages with mild reduction of his projection (size of nose, position of the nose from the face) as well as lifting of his nose. Review of the ‘after photographs are shown at 8-weeks. After surgery although there is still swelling present, a marked improvement can be seen, with a more balanced profile and the patient was very happy with the results. Dr. De Silva believes in spending extra time with each patient to ensure each result is as good as it can possibly be. Dr. De Silva specialises in natural looking rhinoplasty, each surgery is tailored to the individual needs of each patient, for this reason most rhinoplasty takes 3 hours for most patients.

This Asian woman did not like the appearance of her nose the relatively large width and low bridge.

Read more

With a consequence of her ethnicity the anatomy of his nose was characterised by a relatively thick skin and a low nasal bridge. Dr. Julian De Silva completed an Asian rhinoplasty that included specialised grafting techniques to improve the definition in her nasal bridge and tip in addition to conservative narrowing of his nostrils. Dr. De Silva supported her nose with supporting grafts to maintain the shape of her nose long-term. The reviewed photograph was taken several months after surgery, the photograph shows an improved nasal profile and a narrow more balanced looking nose. At 6-month after Asian rhinoplasty surgery there is swelling present and this will continue to improve over the next 12-months as more definition will be apparent in the nasal bridge and nasal tip.

This Caucasian woman had experienced unfortunate trauma to her nose that resulted in a sunken bridge, that had markedly changed her facial appearance.

Read more

She looked for a facial plastic surgeon who would be able to help restore the natural appearance of her including her bridge. After a detailed consultation with Dr. De Silva she underwent a revision rhinoplasty with under sedation anaesthesia. Dr. De Silva shaped utilised specialised graft material and surgical techniques to restore her natural bridge and nose shape. Dr. De Silva also improve her symmetry and breathing as her nose after the trauma had become twisted to the left side. Dr. De Silva discusses with each patient realistic expectations from surgery as perfection is very challenging to achieve. The after photos at 6months show a markedly improved of her nasal bridge, resulting in her achieving the same appearance and shape that she had before her injury. The patient was very happy with the natural looking final result. Link to video testimonial: https://youtu.be/c_m8xlI4YxE

This woman in was unhappy about the unevenness of her tip and unflattering shape of her nose, with a twisted tip following previous surgery.

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On review of her photographs he had a twisted asymmetrical tip and weak cartilages. She had wanted a very natural looking result. Dr. Julian De Silva performed an open revision rhinoplasty with shaping of her nasal tip and the use of specialist graft material from her ear to ensure a stable long lasting result. Cartilage graft taken from her ear did not change the appearance shape or structure of her ear, however can be sensitive for several weeks after the surgery in some patients. Review of the ‘after photographs are shown at 8-weeks. After surgery shows a more balanced profile and the patient was very happy with the results. Dr. De Silva believes in spending extra time with each patient to ensure each result is as good as it can possibly be. Dr. De Silva specialises in natural looking rhinoplasty, each surgery is tailored to the individual needs of each patient, for this reason most revision rhinoplasty takes at least 3 hours for most patients.

This man in his 20s had not liked his small chin and crooked nose for many years.

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He looked for a facial plastic surgeon who would be able to help restore the natural appearance of his nose including his crooked bridge. He had previously undergone septoplasty that can alter the underlying anatomy of the nose. On review of his photographs he had a moderate hump no the bridge of his nose with relatively large and undefined nasal tip. Dr. De Silva completed a revision rhinoplasty reshaping his natural bridge and redefining his nasal tip. Dr. De Silva also improved his symmetry and breathing. Dr. De Silva discusses with each patient realistic expectations from surgery as perfection is very challenging to achieve. The after photos at 2months show a markedly improved of his nasal bridge and tip that was more in proportion to the rest of his face. The patient was very happy with the natural looking final result.

This Caucasian man in his 20s had disliked the width of his nose for many years and was looking for a conservative improvement in the size and width of his nose, while maintaining his natural profile and shape.

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He conducted a thorough search to find a plastic surgeon who would be able to complete his request. On meeting with Dr. De Silva, both his objectives from surgery and expectations were discussed. He underwent rhinoplasty with septoplasty under sedation anaesthesia (twilight anaesthesia). Dr. De Silva utilised specialised cartilage techniques to refine and reshape the cartilages narrowing both the bridge of his nose and nostrils. Narrowing the nostrils can be challenging as some techniques can result in visible scarring, Dr. De Silva prefers to make any scars relatively discrete on the underside of the nostrils, hiding scars in the natural shadows of the nose. The before and after photos at 6weeks shows an improvement in the width of the nose, although there is still swelling present. His scars are relatively discreet and will continue to improve for 12-18months after the surgery. The patient was very happy with the results of his surgery.

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This man in his 20s had not like the appearance of his nose for many years, particularly the hump on his nasal bridge and reduced breathing on the right side.

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He looked for a facial plastic surgeon who would be able to help restore the natural appearance of his nose including his bridge and improve his breathing. After a detailed consultation with Dr. De Silva he underwent a rhinoplasty and septoplasty under sedation anaesthesia. Dr. De Silva utilised specialised surgical techniques to conservatively reduce and reshape his natural bridge and straighten the centre part of his septum. Dr. De Silva discusses with each patient realistic expectations from surgery as perfection is very challenging to achieve. The after photos at 2months, although swelling is present, show a markedly improved of his nasal bridge that was more in proportion to the rest of his face. The patient was very happy with the natural looking final result.

This woman in her 20s was unhappy about the bulbous appearance of the tip of her nose, large size (over-projection) of her nose and tip that droops on smiling.

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On review of her photographs she had a relatively large tip in proportion to her face with marked nostril asymmetry and a septal deviation. Dr. Julian De Silva performed an open rhinoplasty with straightening of septal deviation, shaping of her nasal tip and narrowing her nostrils. In addition the depressor muscle that dips her nose on smiling was softened. Review of the ‘after photographs are shown at 10-weeks. After surgery although there is still swelling present, a marked improvement can be seen, with a more balanced profile, with a smaller and more proportioned nose. There was marked nostril asymmetry before the surgery and although this was improved with the surgery with small nostrils after surgery, it is not possible to completely correct this while making the nose smaller (graft material would improve the symmetry of the nostrils however would potentially widen the nose). The patient was very happy with the results and her video testimonial can be seen below. Dr. De Silva specialises in natural looking rhinoplasty, each surgery is tailored to the individual needs of each patient.www.youtube.com/watch?v=8KfYF6GCrwE&authuser=0

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This Caucasian nurse in her 60s had undergone two previous rhinoplasties by ENT surgeons that had resulted in unfavourable result.

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She had always been bothered by the appearance of her nose, the relatively high and ‘protruding’ bridge and wished to have a shorter, narrower and more feminine nose. After a detailed consultation with Dr. De Silva, discussing both expectations and realistic outcomes from multiple revision surgery, she underwent a revision rhinoplasty with under sedation anaesthesia. Dr. De Silva shaped the underlying cartilage and utilised specialised graft material and surgical techniques to restore a more` feminine natural bridge and nose shape. Dr. De Silva discusses with each patient realistic expectations from surgery as perfection is very challenging to achieve. The after photos at 3months show a marked improvement in her nasal bridge, resulting in her achieving the feminine appearance and shape that she had sought for many years. The patient was very happy with the natural looking final result.

This Asian woman in her 20s did not like the appearance of her nose the relatively large width, lack of definition, low nasal bridge and possible history of keloid scarring.

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She looked for a surgeon who specialised in Asian rhinoplasty to improve the appearance of her nose and was personally recommended to see Dr. De Silva. After a detailed consultation with Dr. De Silva she underwent open ethnic rhinoplasty with septoplasty under sedation anaesthesia. Dr. De Silva shaped her nasal tip cartilage with a combination of sculpting techniques and dissolvable stitches, the use of speciliased graft material to increase the definition the in her nasal bridge and tip, and narrowing of her nostrils (alar reduction). After surgery there is a marked improvement in the definition in her nose and the after photographs taken 3-months after surgery show a more defined nasal bridge and narrower more refined nasal tip. Dr. De Silva supported her nose with supporting grafts to maintain the shape of her nose long-term. At 3-months after ethnic rhinoplasty surgery there is swelling present and this will continue to improve over the next 12-18 months as more definition will be apparent in the nasal bridge and nasal tip.www.youtube.com/watch?v=TSxDElmCCR8&authuser=0

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This Caucasian woman in her 20s was getting married and was looking to improve specific characteristics of her nose that had bothered her for many years.

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She particularly noticed the shape of the bridge, the width of her nostrils, the relative large amount of nostril show from the side and asymmetry. After a detailed consultation with Dr. De Silva, including a discussion of both expectations from surgery and realistic outcomes, she underwent open ethnic rhinoplasty with septoplasty under sedation anaesthesia. Specialised graft material was required to improve the symmetry in her nose and subtle alterations of the nose to reduce the nostril show from her right and left profile views. The shape of her nose was improved and the subtle depression on the left nasal bridge improved. She was very happy with the results from her surgery.
Request a consultation at our office in London to take the next step and learn more about your cosmetic options. You can call the London Centre for Advanced Facial Cosmetic Surgery at 020 8748 2860 to schedule your appointment with Dr. De Silva.

This European Caucasian woman had not liked the general shape of her nose for many years, in particular the width of her nose with lack of definition in her tip, wide nostrils and relatively large size (over-projection).

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She looked to find a plastic surgeon who specialized in Rhinoplasty and was personally recommended to Dr. De Silva. On meeting with Dr. De Silva, both her objectives from surgery and expectations were discussed, one of the characteristics of her ethnicity included thicker ethnic skin that requires specialist techniques to improve. In addition Dr. De Silva discussed with her relatively small chin that was relevant to the proportions of her face, as it can result in a larger looking nose as a result of a small chin. She underwent an open rhinoplasty with a chin implant, Dr. De Silva utilised specialist graft and cartilage techniques to give her improved definition and a more elegant nasal profile with narrower and more elegant features. The after photographs is at only at 2months and the tip will further improve over an 18-month period after rhinoplasty with thicker skin. Dr. De Silva utilised specialized anti-swelling medication after surgery on several occasions to further improve the definition and shape of her nose after Asian Rhinoplasty. She was very happy with the results of her natural looking surgery and a video of her experience with Dr. De Silva can be seen below:www.youtube.com/watch?v=6KwKRX9j5zk

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After

Before

After

This Asian woman in her 20s did not like the relative prominence of her nose, especially with certain angles the hump on the bridge of her nose catching the light.

Read more

She wanted to balance her nose with the rest of her features she started researching different rhinoplasty surgeons and decided to contact the London Centre for Advanced Facial Cosmetic Surgery for a consultation. When she came in for her appointment, she expressed her concerns to her surgeon and told him how the shape of her bridge, the width of her nose and movement with smiling. She wanted to have a more refined nose with improved bridge with a very natural result. After listening to her concerns, her surgeon, Dr. De Silva assured her that he could achieve the results she wanted using a closed rhinoplasty technique. By hiding all small incisions inside the nostril, her surgeon was able to sculpt the nasal cartilages and reshape the bone avoiding and cuts in the skin and without having to leave visible scarring. The final result shows the appearance of her nose after surgery. There was a marked improvement in the shape of her nose with minimal swelling and a natural looking result. With Dr. De Silva’s novel techniques only 10% of his patients have bruising after surgery, and most bruising if it does occur is relatively mild and resolves within 2 weeks.
Request a consultation at our office in London to take the next step and learn more about your cosmetic options. You can call the London Centre for Advanced Facial Cosmetic Surgery at 020 8748 2860 to schedule your appointment with Dr. De Silva.

This South-East Asian woman in her 20s did not like the appearance of her nose the relatively large nose, high nasal bridge and difficulty breathing including Hayfever and a deviated septum.

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She had researched considerable for a surgeon who would be able the appearance of her nose and had attended five previous consultations. After a detailed consultation with Dr. De Silva she underwent open ethnic rhinoplasty with septoplasty under sedation anaesthesia. Dr. De Silva shaped her nasal tip cartilage with a combination of sculpting techniques and special stitches, reduced her nasal bump with the signature specialised micro-instrument and improved her breathing with a combination septoplasty and turbinate procedure. In the after photographs taken 6-weeks after surgery, although swelling is present in the nasal tip, the photos show a more refined appearance, feminine nasal bridge and subtly raised nasal tip. Although the central septum was straightened at the time of surgery, Hayfever cannot be improved with known surgical techniques and is the same after rhinoplasty. Her scar is slightly pink, and will continue to improve until it becomes a fine line after a period of months, and can be hidden with concealer makeup before then. At 3-months after ethnic rhinoplasty surgery there is swelling present and this will continue to improve over the next 12-months as more definition will be apparent in the nasal bridge and nasal tip.www.youtube.com/watch?v=JoPgd7FDyZc&t=11s

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This Caucasian woman was looking to undergo refinement rhinoplasty. She noticed minor imperfections in the shape of her nose and came to see Dr. Julian De Silva as a specialist in Facial Plastic Surgery for refinement of her nose.

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Dr. De Silva completed a refinement rhinoplasty with conservative shaping of nasal bridge and her nasal tip to give a more feminine shape. Review of the ‘post’ photograph shows a more refined nasal tip with subtle elevation of her nose keeping the same characteristics of her face at the same time as shortening her nose and resulting in better facial harmony. Swelling is still present at the lower parts of her nose at 6weeks after surgery and this will continue to improve over a period of months. Refinement rhinoplasty can be challenging in that the changes required are all intricate detail and often they require patience as the improvements may not initially be visible after surgery as they are hidden by swelling. The patient was very happy with the subtle natural looking result.

This man in his 30s had not like the shape of his nose and bump for many years. In addition he had undergone previous trauma to his nose. He looked to find a plastic surgeon that would be able to help guide her for the best possible improvement.

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On meeting with Dr. De Silva, his objectives from surgery and expectations were discussed and Dr. De Silva also advised a chin implant to improve his facial balance. A small recessed chin can by relative proportions make a nose look larger in appearance. He underwent an open rhinoplasty with specialist graft material to give him an improved bridge and a more elegant nasal profile. Dr. De Silva utilised specialised chin implant to improve the projection of his chin and jaw line. Dr. De Silva customizes all chin implants to each individual patients specific needs and natural jaw line. The patient was very happy with the results of his natural looking surgery and please see his video testimonial below:www.youtube.com/watch?v=s-4ojZbRphk&t=94s

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This young woman in her 20s had not liked her nose for many years, she had particularly noticed the bump on the bridge of her nose, asymmetry, nostril irregularity, tip asymmetry and reduced breathing on the right side of her nose.

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She looked for a facial cosmetic surgeon who would be able to both improve the appearance of her nose which had bothered her for her whole life. After a detailed consultation with Dr. De Silva she underwent a rhinoplasty with septoplasty under sedation anaesthesia. Dr. De Silva shaped her nasal tip cartilage with a combination of sculpting techniques and special stitches, reduced her nasal bump with the signatures specialised micro-instrument and improved her breathing with a combination septoplasty and turbinate procedure. She had very thin skin and Dr. De Silva used specialised graft material to enhance the quality of her skin to give her a better long-term result for years to come. After surgery her nose was markedly improved and the after photographs taken only 6-weeks after surgery show a refined nasal tip, feminine nasal bridge and subtly raised nasal tip. The patient was very happy with the natural looking final result.
Request a consultation at our office in London to take the next step and learn more about your cosmetic options. You can call the London Centre for Advanced Facial Cosmetic Surgery at 020 8748 2860 to schedule your appointment with Dr. De Silva.

This Middle Eastern woman in her 30s did not like the appearance of her nose with a high bridge and unflattering profile view, with a droopy nasal tip and relatively wid nostrils..

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With a consequence of her ethnicity the anatomy of her nose was characterised by relatively thick skin, wide nasal tip and large asymmetrical nostrils. Dr. Julian De Silva specialises in ethnic rhinoplasty and completed an ethic rhinoplasty that included specific grafting techniques to improve the definition in her nasal tip in addition shaping her nasal bridge with special instruments. Dr. De Silva supported her nose with supporting grafts to maintain the shape of her nose long-term. The reviewed photograph was taken 3-months after surgery, the photograph shows an improved nasal bridge and profile with a more balanced looking nose. At 3-months after ethnic rhinoplasty surgery there is swelling present and this will continue to improve over the next 12-18 months as more definition will be apparent in the nasal bridge and nasal tip. The open rhinoplasty scar is difficult to see at 3-months after surgery, Dr. De Silva uses multiple stitches and layers to improve the healing of the scar in most patients requiring open rhinoplasty. The patient was happy with results of her rhinoplasty, please see the video testimonial of her experience below:www.youtube.com/watch?v=eon6PZXLUik&authuser=0

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This Afro-Caribbean woman in her 30s was unhappy with the shape of the bridge of her nose, bulbous tip and large nostrils.

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She sought a narrower more defined nose that ideally was in the shape of Rhiana. Dr. Julian De Silva completed an ethic rhinoplasty and septoplasty reducing her nasal bridge with graft material giving her a smooth and more elegant nasal profile, and lifting her tip to correct the droopiness of her nasal tip. Dr. De Silva shapes the graft material to the individual person so no two are identical. In addition Dr. De Silva supported her nose with supporting grafts to maintain the nasal architecture long-term and narrowed her nostrils. There are different techniques that can be used to narrow the nostrils, broadly speaking these can be divided into those with scars that are beneath the nostrils and those on the side of the nostrils. Scars on the side of the nostrils can be quite noticeable and require camouflage make up to hide. Dr. De Silva’s preference is to hide scars under the nose as these are more difficult to see. Narrowing wide nostrils can generally be quite a challenging part of rhinoplasty as most patients have some natural asymmetry of their nostrils and this can be improved however it is difficult to make nostrils completely symmetrical as part of their shape is the underlying natural shape of the cartilage. The reviewed photograph was taken 6-weeks after surgery, the photograph shows an improved nasal profile, with a gently curved nose and overall an attractive and natural looking nose. The patient was very happy with the results of her rhinoplasty.

This Caucasian woman in her 20s had not liked her nose for many years, she had particularly noticed the bump on the bridge of her nose,

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asymmetry of her bridge, the lower part of her nose (termed hanging columella), nasal tip and reduced breathing on the right side of her nose. A natural looking result was very important to her and she looked for a facial plastic surgeon who would be able to improve the appearance of her nose with natural looking result. After a detailed consultation with Dr. De Silva she underwent a rhinoplasty with septoplasty under sedation anaesthesia. Dr. De Silva shaped her nasal cartilage with a combination of sculpting techniques and special stitches, reduced her nasal bump with micro-instruments and improved her breathing with a combination of cartilage grafts and septoplasty procedure. She had very thin skin and Dr. De Silva used specialised graft material to enhance the quality of her skin to give her a better long-term result for years to come. After surgery her nose was markedly improved and the after photographs taken only 6-weeks after surgery show a refined nasal tip, feminine nasal bridge and subtly raised nasal tip. The patient was very happy with the natural looking final result.
Request a consultation at our office in London to take the next step and learn more about your cosmetic options. You can call the London Centre for Advanced Facial Cosmetic Surgery at 020 8748 2860 to schedule your appointment with Dr. De Silva.

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This Caucasian woman in her 20s had not liked her nose since her teenage years, she had particularly noticed the bump on the bridge of her nose, relatively wide and drooping nasal tip and reduced breathing on the right side of her nose.

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After a detailed consultation with Dr. De Silva she underwent a rhinoplasty with septoplasty under sedation anaesthesia. Dr. De Silva shaped her nasal cartilage with a combination of sculpting techniques and special stitches, reduced her nasal bump with micro-instruments and improved her breathing with a combination of septoplasty and turbinate procedure. After surgery her nose was markedly improved and the after photographs taken only 6-weeks after surgery show a refined nasal tip, more feminine nasal bridge and natural looking appearance. The patient was very happy with the natural looking final result, please see the video testimonial of her experience below:youtu.be/mkK4DYEv5ZY

This Asian woman in her 20s did not like the appearance of her nose the relatively large width, lack of definition, low nasal bridge and relatively wide nostril. She looked for a surgeon who specialised in Asian rhinoplasty to improve the appearance of her nose.

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After a detailed consultation, Dr. De Silva discussed with her a relatively small chin that would benefit from a chin implant. With Dr. De Silva she underwent open Asian rhinoplasty with septoplasty and chin augmentation under sedation anaesthesia. Dr. De Silva shaped her nasal tip cartilage with a combination of sculpting techniques and dissolvable stitches, the use of specialised graft material to increase the definition the in her nasal bridge and tip, and narrowing of her nostrils (alar reduction). Dr. De Silva used a large silicone chin implant, however customised the implant sculpting the implant to ensure a more feminine ‘V-shaped’ chin. After surgery there is a marked improvement in the definition in her nose and the after photographs taken 3-months after surgery show a more defined nasal bridge and narrower more refined nasal tip. Dr. De Silva supported her nose with supporting grafts to maintain the shape of her nose long-term. At 4-months after ethnic rhinoplasty surgery there is swelling present and this will continue to improve over the next 12-18 months as more definition will be apparent in the nasal bridge and nasal tip.

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This Caucasian woman in her 20s had not liked her nose for some time, she had particularly noticed the prominent bump on the bridge of her nose, pointy shape that dips on smiling and reduced breathing on the right side of her nose.

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She looked for a facial cosmetic surgeon who would be able to improve the appearance of her nose with natural looking result. After a detailed consultation with Dr. De Silva she underwent a rhinoplasty with septoplasty under sedation anaesthesia. Dr. De Silva shaped her nasal cartilage with a combination of sculpting techniques and special stitches, reduced her nasal bump with micro-instruments and improved her breathing with a combination of septoplasty and turbinate procedure. After surgery her nose was markedly improved and the after photographs taken only 7-weeks after surgery show a refined nasal tip, feminine nasal bridge and subtly raised nasal tip. The patient was very happy with the natural looking final result.

This Afro-Caribbean woman in her 20s was unhappy with the shape of the bridge of her nose, undefined nasal tip and large nostrils and longer distance between her lip and nose (termed philtrum).

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She sought a narrower more defined nose and had previously undergone unsuccessful non-surgical rhinoplasty with filler. Dr. Julian De Silva completed an ethic rhinoplasty and septoplasty with a lip lift, reducing her nasal bridge with graft material giving her a smooth and more elegant nasal profile, and lifting her tip to correct the droopiness of her nasal tip. Dr. De Silva removed the permanent filler that had been used this added over 45minutes to the procedure. Dr. De Silva shapes the graft material to the individual person so no two noses are identical. In addition Dr. De Silva supported her nose with supporting grafts to maintain the nasal architecture long-term and narrowed her nostrils. Dr. De Silva’s preference is to hide scars under the nose as these are more difficult to see. The reviewed photograph was taken 8-weeks after surgery, the photograph shows an improved nasal profile, with a gently curved nose and overall an attractive and natural looking nose. In addition the upper lip has been lifted by a lip lift to give a more feminine and attractive shape to her face. The patient was very happy with the natural looking final result, please see the video testimonial of her experience below:www.youtube.com/watch?v=F0NQoz4HGfo&t=5s

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This Middle Eastern woman in her 30s did not like the appearance of her nose with a high bridge, relatively wide bridge and nostrils.

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With a consequence of her ethnicity the anatomy of her nose was characterised by markedly thick ethnic skin, wide nasal tip and large asymmetrical nostrils. Dr. Julian De Silva specialises in ethnic rhinoplasty and completed an ethic rhinoplasty that included specific grafting techniques to improve the definition in her nasal tip in addition shaping her nasal bridge with special instruments. Dr. De Silva supported her nose with supporting grafts to maintain the shape of her nose long-term. After surgery Dr. De Silva uses anti-inflammatory medicine to reduce swelling and speed up recovery, this is particularly important for patients with thicker ethnic skin. The reviewed photograph was taken 2-months after surgery, the photograph shows an improved nasal bridge and profile with a more balanced looking nose. At 2-months after ethnic rhinoplasty surgery there is swelling present and this will continue to improve over the next 12-18 months as more definition will be apparent in the nasal bridge and nasal tip. The open rhinoplasty scar is difficult to see at 2-months after surgery, Dr. De Silva uses multiple stitches and layers to improve the healing of the scar in most patients requiring open rhinoplasty. The patient was very happy with results of her rhinoplasty.

This Caucasian woman in her 20s had not liked her nose for many years, she had particularly noticed the prominent bump on the bridge of her nose,

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the asymmetry with her nose turning to the left, breathing symptoms and moderately wide nasal tip. She looked for a facial cosmetic surgeon who would be able to improve the appearance of her nose with natural looking result. After a detailed consultation with Dr. De Silva she underwent a rhinoplasty with septoplasty under twilight anaesthesia. Dr. De Silva shaped her nasal cartilage with a combination of sculpting techniques and special stitches, reduced her nasal bump with micro-instruments and improved her breathing with a combination of septoplasty and turbinate procedure. Straightening the nose can be challenging procedure in rhinoplasty as often it is multi-factorial, although graft material can be effectively used to improve symmetry it is sometimes not possible to completely straighten the nose. After surgery her nose was markedly improved and the after photographs taken only 2-months after surgery has swelling present, the photos show a refined shape, feminine nasal bridge and more symmetrical appearance. The patient was very happy with the natural looking final result.

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This Caucasian man in his 20s had disliked the appearance of his nose for many years and was looking for an improvement in particularly the width of his nose, while improving his profile and shape.

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He conducted a thorough search to find a facial plastic surgeon who would be able to complete his request. On meeting with Dr. De Silva, both his objectives from surgery and expectations were discussed. He underwent rhinoplasty with septoplasty under sedation anaesthesia (twilight anaesthesia). Dr. De Silva utilised specialised cartilage techniques to refine and reshape the cartilages narrowing both the bridge of his nose and nostrils. Narrowing the nostrils can be challenging as some techniques can result in visible scarring, Dr. De Silva prefers to make any scars relatively discrete on the underside of the nostrils, hiding scars in the natural shadows of the nose. Although his nose widened with facial expression, this can in itself be difficult to change as this is a consequence of natural movements of the face, however narrowing the nostrils result in less widening of his nose on smiling. The before and after photos at 6weeks shows an improvement in the width of the nose, although there is still swelling present. His scars are relatively discreet and will continue to improve for 12-18months after the surgery. The patient was very happy with the results of his surgery.

This woman in her 40s had not liked her nose for many years, she had not liked the overall shape of her nose. She looked for a facial cosmetic surgeon who specialised in rhinoplasty who may be able to help her.

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She came for an appointment with Dr. Julian De Silva who spent time discussing with her what he would be able to both improve in terms of rhinoplasty and realistic expectations form surgery. After a detailed consultation with Dr. De Silva she underwent an open rhinoplasty with septoplasty under sedation anaesthesia. Dr. De Silva shaped her nasal tip with a combination of sculpting techniques and special stitches, reduced her nasal bump with the signatures specialised micro-instrument and improved her breathing with a combination septoplasty and turbinate procedure. She had relatively thin skin and Dr. De Silva used specialised graft material to enhance the quality of her skin to give her a better long-term result for years to come, this does increase initial swelling after surgery, however use of anti-inflammatory medicine after surgery aids resolution of swelling. After surgery her nose was markedly improved and the after photographs taken only 6-weeks after surgery show a more feminine nasal bridge and shape. The patient was happy with the natural looking final result.

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This Caucasian woman in her 20s had not liked her nose for many years, she had particularly noticed the prominent bump on the bridge of her nose, the relatively wide boxy nasal tip and reduced functional breathing symptoms on her left.

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She looked for a facial cosmetic surgeon who would be able to improve the appearance of her nose with natural looking result. After a detailed consultation with Dr. De Silva she underwent a rhinoplasty with septoplasty under twilight anaesthesia. She recorded her recovery on a day-by-day basis that can be seen on this page:www.londonfacialplasticsurgery.co.uk/rhinoplasty-diary-video
Dr. De Silva shaped her nasal cartilage with a combination of sculpting techniques and special stitches, reduced her nasal bump with micro-instruments and improved her breathing with a combination of septoplasty and turbinate procedure. After surgery her nose was markedly improved and the after photographs taken only 2-months after surgery has swelling present, the photos show a refined shape, feminine nasal bridge and more symmetrical appearance. The patient was very happy with the natural looking final result.www.youtube.com/watch?v=Rgx5m7S4vnY&t=5s

This woman in her 50s had not liked her nose for many years, she had not liked the overall shape of her nose. She looked for a facial cosmetic surgeon who specialised in rhinoplasty who may be able to help her.

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She came for an appointment with Dr. Julian De Silva who spent time discussing with her what he would be able to both improve in terms of rhinoplasty and realistic expectations form surgery. She had a fear of closed spaces, claustrophobia, Dr. De Silva’s team are used to helping patients with phobias included needle phobia and claustrophobia. After a detailed consultation with Dr. De Silva she underwent an open rhinoplasty with septoplasty under sedation anaesthesia. Dr. De Silva shaped her nasal tip with a combination of sculpting techniques and special stitches, reduced her nasal bump with the signatures specialised micro-instrument and improved her breathing with septoplasty. She had relatively thin skin and Dr. De Silva used specialised graft material to enhance the quality of her skin to give her a better long-term result for years to come, this does increase initial swelling after surgery, however use of anti-inflammatory medicine after surgery aids resolution of swelling. After surgery her nose was markedly improved and the after photographs taken only 6-weeks after surgery show a more feminine nasal bridge and shape. The patient was happy with the natural looking final result.
Request a consultation at our office in London to take the next step and learn more about your cosmetic options. You can call the London Centre for Advanced Facial Cosmetic Surgery at 020 8748 2860 to schedule your appointment with Dr. De Silva.

Before

After

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This Caucasian woman in her 40s had not liked her nose for many years, she had particularly noticed the bump on the bridge of her nose and unflattering shape.

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A natural looking result was very important to her, she had been for several consultations prior to meeting Dr. De Silva After a detailed consultation, Dr. De Silva discussed with her both objectives from her surgery and realistic expectations including her relatively small chin that would benefit from a chin implant, and upper blepharoplasty. After a detailed consultation with Dr. De Silva she underwent a rhinoplasty, upper blepharoplasty and chin implant procedures under twilight anaesthesia. Dr. De Silva shaped her nasal cartilage with a combination of sculpting techniques and special stitches, reduced her nasal bump with micro-instruments and improved her breathing with a combination of septoplasty and turbinate procedure. After surgery her nose was markedly improved and the after photographs taken only 6-weeks after surgery show a feminine nasal bridge, refined nasal tip and improved facial proportions between her nose and chin. The patient was very happy with the natural looking final result.

This South-East Asian woman in her 20s did not like the appearance of her nose the relatively large nose, high nasal bridge and droopy nasal tip particularly on smiling.

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She was keen to keep certain aspects of her nose such as the tip and a natural looking appearance was very important. After a detailed consultation with Dr. De Silva she underwent open ethnic rhinoplasty with septoplasty under sedation anaesthesia. Dr. De Silva shaped and lifted her droopy nasal tip cartilage with a combination of sculpting techniques and special stitches, reduced her nasal bump with the signature specialised micro-instrument. There is a small muscle that can pull the tip of the nose down, causing drooping of your nose on smiling, Dr. De Silva is able to soften this muscle, to reduce drooping of the nose tip. In the after photographs taken 6-weeks after surgery, although swelling is present in the nasal tip, the photos show a more refined appearance, feminine nasal bridge and subtly raised nasal tip. At 6-weeks after ethnic rhinoplasty surgery there is swelling present and this will continue to improve over the next 12-months as more definition will be apparent in the nasal bridge and nasal tip. The patient was very happy with the results from her ethnic rhinoplasty.

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This patient had undergone rhinoplasty with a local plastic surgeon, although she had noticed an improvement she had disliked the overall appearance particularly the shape of the bridge (fullness termed a pollybeak) and lower aspect of her nose that hung down (termed hanging columella).

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She came for an appointment with Dr. Julian De Silva, specialising in facial cosmetic and plastic surgery only, who spent time discussing with her what he would be able to both improve in terms of rhinoplasty and realistic expectations form surgery. Dr. De Silva completed revision open rhinoplasty, improving both the shape of her nose and her hanging columella. A year after surgery all her swelling has resolved showing a good improvement in the shape of her nose, and minimal scar from open revision surgery. Revision rhinoplasty is a challenging procedure and all revision surgery is about an improvement as opposed to perfection.

This patient had undergone rhinoplasty with a local plastic surgeon, although he had noticed an improvement he had a bump left over the bridge that reduced the balance of his face.

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He had other medical conditions that made surgery unsuitable at present. He came for an appointment with Dr. Julian De Silva, specialising in facial plastic surgery only, who spent time discussing with him what he would be able to both improve in terms of rhinoplasty and realistic expectations form surgery. As an alternative to surgery, Dr. De Silva completed a non-surgical rhinoplasty, using an HA filler to improve the shape of his nose. The after photograph shows immediately after treatment and improvement in the shape of his nose. For some patients, non-surgical treatment may offer an alternative to surgery, although temporary may benefit patients who are unsuitable for surgery. Care is required in the use of fillers in the nose as then can have rare yet serious implications to the skin, scarring and vision. In addition adding volume to a patient who has a relatively large nose is generally unflattering as it will result in an even larger appearance. Not all fillers are equal and some fillers are best avoided in the nose, including permanent fillers and HA fillers which have water-liking (termed hydro-philic) properties. For some patients particularly relatively minor imperfections the use of an appropriate filler and technique can enhance appearance avoiding surgery.

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This Caucasian man in his 20s had not liked the shape of his nose for many years and was looking for an improvement in particularly the bridge of his nose, while improving his profile and breathing that was reduced on the left side.

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He conducted a thorough search to find a facial plastic surgeon who would be able to complete his request. On meeting with Dr. De Silva, both his objectives from surgery and expectations were discussed. He underwent rhinoplasty with septoplasty under sedation anaesthesia (twilight anaesthesia). Dr. De Silva utilised specialised cartilage techniques to refine and reshape the cartilages reshaping the bridge of his nose and reducing his nostril show. His septum was very deviated, Dr. De Silva took extra time to straighten the centre part of his cartilage and boney septum. Key in reshaping the bridge of a man, is maintaining the shape and avoiding over reduction of the bridge that can result in a more feminine appearance. The after photos at 6-weeks shows a natural improvement in the shape of his nose, although there is still swelling present. His nose will continue to improve for 12-months after the surgery as further swelling reduces. The patient was very happy with the results of his surgery and improvement in breathing.